Treatment of neurodegenerative conditions

ABSTRACT

A method is provided for treating a patient in need of therapy for a neurodegenerative disease comprising administering to that patient a therapeutically effective dose of a lipid glyceride comprising a glycerol moiety and a fatty acid moiety, the fatty acid moiety being selected from the group consisting of γ-linolenic acid, dihomo-γ-linolenic acid and arachidonic acid characterised in that the selected fatty acid moiety is attached to the glycerol moiety at its sn-2 position. Preferably the method is that wherein the lipid is administered for a duration and at a dose sufficient to maintain or elevate TGF-β1 levels in the patient to therapeutic levels.

The present invention relates to a method for treating neurodegenerativeconditions, particularly those in which increase in transforming growthfactor β (TGF-β) is beneficial, particularly TGF-β1. More particularlythe present invention provides treatment for neurodegenerativeconditions, particularly those such as demyelinating diseases, such asmultiple sclerosis, Alzheimer's and Parkinsons diseases and thedegenerative sequelae associated with head trauma, stroke andintracranial bleeds, whereby neuronal function may be improved orrestored from an impaired condition, eg. by remyeleination.

Further provided are novel use of known and novel compounds comprisingunsaturated fatty acid moieties for the manufacture of medicamentscapable of effectively treating such conditions, more particularly beingcapable of achieving previously unattained levels of success with regardto recovery of neurological function.

The inventor's copending unpublished patent application PCT/GB04/002089,incorporated herein by reference, relates to the use of plant and fungaloils for the treatment of neurodegenerative diseases. These oils havehigh percentages of the essential fatty acid γ-linolenic acid (GLA) atthe sn-2 position of their lipids, typically being over 40% of the sn-2fatty acid total of the oil.

It is well reported in the literature that essential fatty acids (EFAs)of the n-3 and n-6 unsaturation pattern have beneficial effect in a widevariety of human physiological disorders, including autoimmune diasese(WO 02/02105). Harbige (1998) Proc. Nut. Soc. 57, 555-562 reviewed thesupplementation of diet with n-3 and n-6 acids in autoimmune diseasestates, and particularly noted evidence of benefit of γ-linolenic (GLA)and/or linoleic acid (LA) rich oils.

Bates et al noted that lipid oils comprising a mixture of linoleic acidand γ-linolenic acid residues had been suggested back in 1957 to bepossibly more efficacious in treating inflammation and autoimmunediseases, but found that at 3 g oil per day (Naudicelle Evening Primroseoil 7:1 LA:GLA) patients who had relapses became more ill on the trialoil than on the control.

Although the aetiology of MS remains unknown studies have shown that MSpatients have higher than normal neuro-antigen autoreactive T-cellslevels. These T-cells react inter alia to myelin basic protein (MBP) andmyelin oligodendrocyte glycoprotein (MOG) and are in an increased stateof activation compared with healthy controls. The actual processes ofaxonal damage e.g. chronic inflammation, demyelination and astrogliosisin MS is complex but white matter inflammation and demyelination areconsidered to determine disease severity, whilst recent studiessuggested that axonal damage in MS begins in the early stages of thedisease and contributes to disability (De Stefano et al, 2001).

Experimental autoimmune encephalomyelitis (EAE) is the most frequentlyused animal model for immune mediated effects of MS. Studies in theguinea-pig have shown that linoleic acid partially suppresses theincidence and severity of EAE (Meade et al (1978)). (Harbige et al(1995), 1997b) demonstrated disease modifying effects of linoleic acidand γ-linolenic acid on clinical and histopathological manifestations ofEAE. Depending on dose, γ-linolenic acid was fully protective in acuterat EAR whereas linoleic acid had dose-dependent action on the clinicalseverity but did not abolish it.

Despite these experimental findings, it is recognised that the humandisease, multiple sclerosis, is highly complex and can be converselyexacerbated and ameliorated by the activity of T-cells and other immuneresponse factors. It is thought that the n-6 fatty acids promoteautoimmune and inflammatory disease based upon results obtained withlinoleic acid only. TGF-β1 and PGE₂ production has been shown to beincreased non-specifically in γ-linolenic acid fed mice ex vivo. TGF-β1has been reported to protect in acute and relapsing EAE ((Racke et al(1993); Santambrogio et al (1993)), and PG inhibitors such asindomethacin augment, and thus worsen, the disease (Ovadia & Paterson(1982)).

Cytokines are implicated in the pathogenesis of MS, with many studiesshowing an increase in myelinotoxic inflammatory cytokines (TNF-α, IL-1βand IFN-γ) coinciding with the relapse phase of the disease. Conversely,levels of the anti-inflammatory and immunosuppressive cytokinetransforming growth factor-beta1 (TGF-β1) appear to be reduced during aphase of relapse and increase as the patient enters remission. Thus thebalance between biologically active TGF-β1 and the pro-inflammatoryTNF-α, IL-1β and IFN-γ appears to be dysregulated during MSrelapse-remission.

During natural recovery phase from BAB, TGF-β1-secreting T-cells inhibitEAE effector cells, TGF-β1 is expressed in the CNS and, inoral-tolerance-induced protection in EAE, TGF-β and PGE₂ are expressedin the brain (Karpus & Swanborg (1991); Khoury et al (1992)). Harbige((1998) concluded that dietary γ-linolenic acid effects on EAE aremediated through Th₃-like mechanisms involving TGF-β1 and possiblythrough superoxide dismutase antioxidant activity.

Borage oil (typically 20% to 23% γ-linolenic acid and 34 to 40% linoleicacid per 100% fatty acid content) and Mucor javanicus fungal oil (seeFIG. 1) have been shown to be effective in the EAE animal model used toidentify MS candidates, whilst never having been shown to besignificantly effective in the human disease. High levels of linoleicrich oil containing low levels of γ-linolenic acid (EPO:linoleicacid:γ-linolenic acid 7:1) partially suppressed the incidence andseverity of EAE in rat (Mertin & Stackpoole, 1978) whereas the Bates'Naudicelle study referred to above led to worsening of patients. Inspite of the use of Borage oil and other GLA/LA containing oils such asEvening Primrose oil by multiple sclerosis sufferers over the past 30years or so, the vast majority of patients fail to recover from thedisease, showing no significant improvement, with the underlying diseasecontinuing to progress to death.

It has been suggested to use, inter alia, γ-linolenic acid and linoleieacid rich. Borage oil as a means to provide immuno-suppression inmultiple sclerosis (U.S. Pat. No. 4,058,594). Critially, the dosesuggested is 2.4 grams of oil per day and no actual evidence of efficacyis provided. This is much lower than the low 5 g/day dose found to beineffective in vivo in man in the PCT/GB04/002089 study.

Other more dramatic immunosuppressant treatments, including T celldepicters and modulators such as cyclophosphamide, are also shown to beeffective in the EAE model, but where these are employed in the humanmultiple sclerosis disease symptoms improve, but the underlying diseasecontinues to progress. T-cells indeed produce beneficial cytokines, suchas TGF-β1, as well as deleterious ones in man. David Baker of Instituteof Neurology, UK summed up the disparity between what is effective inthe EAE and in MS with a paper entitled ‘Everything stops EAE, nothingstops MS’ at the 10^(th) May 2004 UK MS Frontiers meeting of the UK MSSociety.

It is clear that immunos⁻uppression alone cannot cure MS. This is almostcertainly due to a fundamental underlying metabolic disorder in MSpatients, in addition to the autoimmune disease, that leads to membraneabnormality, cytokine dysregulation and subsequent immune attack andlesioning. Although patients go into remission in relapse-remittingdisease, the underlying demyelination proceeds.

The ‘gold standard’ treatment for MS remains interferon, such as withβ-Avonex ®, Rebif ® and other interferon preparations. This goldstandard treatment only addresses needs of some, eg 30%, of the patientsand even in these symptom improvement is restricted to reduced severityof relapses. Whilst symptoms may be reduced in a proportion of patients,the disease tends to progress to further disability and death due tounderlying degeneration.

In their as yet unpublished PCT/GB04/002089 study the present inventorshave surprisingly determined that with compliance to a ‘high dose’treatment with triglyceride oil containing high levels of sn-2γ-linolenic acid (>40% of residues at the sn-2 being of γ-linolenicacid) with suitable accompanying fatty acid content, remarkable levelsof improvement in almost all symptoms of MS can be achieved, waysurpassing that provided by the current gold standard treatment. Suchsuccess is particularly surprising in the light of the prior use ofother γ-linolenic acid containing preparations without success, such asthe Naudicelle study.

The PCT/GB04/002089 study shows that over an 18-month period, patientstaking high dose (15 g/day) selected high sn-2 γ-linolenic acid borageoil showed significant (p<0.001) and marked improvements in EDSS score,a reduced rate of relapse, symptomatic relief of muscle spasticity andpainful sensory symptoms, and improved objective measures of cognitivefunctions. Low doses of 5 g/day of this borage oil were without effect.

Patients taking the highest dose of this borage oil maintained theirlevel of peripheral blood mononuclear cell production (PBMC) of TGF-β1during the trial period, their pro-inflammatory cytokines TNF-α andIL-1β were significantly and markedly (<70%) reduced and they eithermaintained or increased the PBMC membrane long chain omega-6 fatty acidsdihomo-γ-linolenic acid (DHLA) and arachidonic acid (AA) in contrast topatients taking placebo who demonstrated loss of these fatty acids overthe course of the trial period.

This whilst immuno-suppression would be expected to reduce increase ofactive lesioning and neurodegeneration, the high sn-2 GLA oil treatmentapparently targeted maintenance and/or increase of key membrane lipidcomponents that are otherwise specifically lost in MS, being consistentwith a correction of a metabolic defect not otherwise effectivelytreated by current therapies. The fact that the low dose (5 grams/day)had no effect on this supports such determination.

γ-Linolenic acid (18:3n-6, or GLA) is known to be rapidly converted tolonger-chain omega-6 polyunsaturated fatty acids dihomo-γ-linolenic acidand arachidonic acid in vivo (Phylactos et al 1994, Harbige et al 1995,2000). Therefore to determine how to increase the level of membrane longchain omega-6 fatty acids in MS the inventors have reviewed theirresults obtained with several GLA-containing oils:—both fungal (fromMucor javanicus) and plant (Borago officianalis), Evening primroseOenothera spp. or Blackcurrant Ribes spp) as well as a synthetic tri-GLAoil as GLA delivery systems in an in vivo experimental animal model ofMS known as chronic relapsing experimental autoimmune encephalomyelitis(CREAE).

Induction of EAE in rats does not produce histological features ofdemyelination (Brosnan et al 1988) but induces an acute mono-phasicdisease pattern, unlike MS which is characterised by CNS demyelinationand is in the majority of cases clinically relapsing-remitting. Chronicrelapsing and demyelinating EAB models (CREAE) however are characterisedby demyelination and relapse phases. With the demonstration that myelinoligodendrocyte glycoprotein (MOG) is an important neuroantigenic targetin MS (Genain et al 1999) and the demonstration of far greater responsesof peripheral blood auto-reactive lymphocytes to this neuroantigen,compared with MBP, in MS (Kerlero de Rosbo et al 1993, 1997) MOG inducedCREAE has become the animal model of choice with features closelyresembling those observed in MS (Fazakerely et al 1997, Genain et al1999, Amor et al 1994).

Evidence from the inventor's CREAE and rat EAE feeding studies indicatesthat an enriched blackcurrant seed oil (72% w/w 18:3n-6, GLA) did notprotect against EAE (see Table 3) Importantly blackcurrant seed oil hasa low sn-2 GLA with most of the GLA in the sn-1 and sn-3 positions(Lawson and Hughes 1988). Furthermore a structured triacylgcerolcontaining three GLA moieties (TG-GLA) provided protective effectssimilar to that of the borage oil used in CREAE (Table 2). This wouldalso be consistent with the sn-2 GLA being important i.e. the outer pairsn-1 and sn-3 GLA being enzymatically removed in vivo and probablyundergoing oxidation leaving the sn-2 GLA only. This selectivehydrolysis arises from the known ability of specific lipases to removethe sn-1 and sn-3 fatty acids from triacylgycerol molecules but anapparent protection of the sn-2 position in vivo (Lawson and Hughes1988, Kyle 1990).

This review has led the inventors to postulate that glycerides havingsn-2-γ-linolenic acid, dihomo-γ-linolenic acid or arachidonic acidresidues will be superior in correcting MS metabolism even to the highsn-2-γ-linolenic acid Borage oil of their earlier trial. This wouldallow lower doses of lipid to be taken and/or possibly decrease the timeof treatment which would result in beneficial effect.

Table 3 of EP 0520624 (Efamol Holdings) compares the triglyceridecontent of Evening Primrose and Borage Oils, the former being taught tobe more therapeutically effective than the latter for a variety of GLAresponsive disorders. This document indicates Borage oil to have twentyseven different trigyceride components, only 20% of which have sn-2 GLA.Page 3, lines 40-42 notes that biological testing has shown that equalamounts of GLA may indeed have very different effects when that GLA issupplied as different oil sources. Crucially, it then directs the readerto one particular fraction present in Evening Primrose Oil (EPO), butnot Borage Oil, as being responsible for the former's superior effect inraising PGE1 (see EP 0520624 Chart page 4 and Table 2) and thusanti-inflammatory effect: that fraction being identified asdi-linoeoyl-mono-gamma-linolenyl-glycerol (DLMG) which it states to be18 to 19% of the total triglyceride in EPO. Crictically, page 6 clearlyteaches that the position of the GLA, in sn-1, 2 or 3, is not importantto this effect.

Dines et al (1994) Proceedings of the Physiological Society, AberdeenMeeting 14-16 September 1994 report on studies of treatment of diabeticneuropathy neuronal damage with γ-linolenic acid containing oils of thetype advocated by EP 0520624 and again note that Borage Oil was not veryeffective in treating this neurodegeneration whereas Evening primroseoil was. The paper concludes that Borage Oil contains other constituentsthat interfere with GLA activity.

The present inventors now set out, in view of their results for highsn-2-γ-linolenic acid Borage Oil, to demonstrate that it is indeed thepresence of an sn-2-γ-linolenic acid, dihomo-γ-linolenic acid orarachidonic acid residue in a glyceride, particularly a triglyceride,that gives it efficacy in treating EAE, CREAE and the human disease MS.

In a first aspect the present invention provides a method of treating apatient in need of therapy for a neurodegenerative disease comprisingadministering to that patient a therapeutically effective dose of adefined structure lipid glyceride comprising a glycerol moiety esterifedwith one or more fatty acid moieties, characterised in that the lipidhas a fatty acid moiety at the sn-2 position selected from the group ofresidues consisting of residues of γ-linolenic acid, dihomo-γ-linolenicacid and arachidonic acid.

Particularly advantageously treated neurodegenerative diseases are thoseinvolving demyelination. The present method specifically arrestsunderlying neurodegeneration and restores neuronal function.Particularly the method normalises neuronal membrane composition, andrestores healthy PBMC spontaneuosly released. TGF-β1/TNFα a ratios andthe ratios of TGF-β1 with other PBMC released cytokines. Mostadvantageously the method arrests neurodegeneration in multiplesclerosis of all types but particularly relapsing remitting, primaryprogressive and chronic progressive MS and the restoration, in part orcompletely, of neuronal function such as measured, eg. By MRI or CATscan or by EDSS score. Such method may also be used in treatment ofcerebral impail nent after stroke, head trauma and intracranial bleedingwhere there is demyelination or neuronal damage. Further application isprovided in treating other chronic demyelination such as in Alzheimer'sand Parkinson's disease.

Preferably the the lipid is administered for a duration and at a dosesufficient to maintain or elevate TGF-β levels in the patient totherapeutic levels. By therapeutic levels is meant levels at leastconsistent with healthy subjects. Preferably the dose is such as toproduce a TGF-β1/TNF-α ratio spontaneously released from peripheralblood mononuclear cells (PBMCs) isolated from blood of a patient, after18 months of daily dosing, of 0.4 to 3.0, at least 0.5, more preferablyat least 0.75 and most preferably at least 1. Preferably the dose issuch as to produce a TGF-β1/IL-1β ratio in blood of a patient, after 18months of daily dosing, of at least 0.5, more preferably at least 0.75and most preferably at least 1. Preferably said levels are producedafter 12 months and more preferably after 6 months.

Typically the amount of lipid administered daily will be between 0.5 and30 grams, orally dosed, still more preferably between 1 and 20 grams andmost preferably between 1 and 18 grams, typically 3 to 5 grams.

Where the sn-2 moiety is that of a γ-linolenic acid residue, the dosemay be toward the higher end of these ranges, particuarly where the sn-1and sn-3 moieties are relatively inert, eg. being metabolically utilisedacids such as saturated fatty acids. Where the sn-2 moiety is that of adihomo-γ-linolenic acid residue, the dose may be less, whilst where thesn-2 moiety is that of an aracidonic acid residue, efficacy is higher,but dosing should be more cautious, due to possibilities of unwantedside effects at higher levels.

More preferably the method is characterised in that the lipid is amonoglyceride, diglyceride or triglyceride containing the at least onesn-2 γ-linolenic acid, dihomo-γ-linolenic acid or arachidonic acidmoiety of general Formula I below:

wherein R¹ and R³ are independently selected from hydrogen and acylgroups,

and R² is selected from the group consisting of γ-linolenic acid,dihomo-γ-linolenic acid and arachidonic acid residues.

For the purpose of the present invention acyl groups are defined ascomprising at least one carbonyl group on the end of an optionallysubstituted hydrocarbyl chain selected from alkyl and alkenyl chains,the carbonyl group being directly attached by its carbon to the oxygenof the glycerol residue shown in Formula 1.

Preferred acyl groups R¹ and R³ are saturated fatty acid moities offormula —CO—(CH₂)_(n)—CH₃, wherein n is an integer selected from 1 to22, more preferably being 4 to 16, still more preferably being from 5 to12, most preferably being from 6 to 10. Particularly preferred acylgroups are those of caprylic and capric acids, particularly being1,3-dicaprylic or 1,3-dicapric glycerols having the γ-linolenic acid,dihomo-γ-linolenic acid or arachidonic acid moiety at the sn-2 position.

Preferred glycerides for use in the invention are triglycerides.

U.S. Pat. No. 4,701,469 describes some potential triglycerides fornutraceutical use that the present inventors have determined may be usedin the method of the invention, although it only specifically describes1,3-dioctanyl triglycerides wherein the sn-2 acid is of an EFA, only1,3-dioctanoyl eicosapenta glycerol is described as having beenprepared. These are said to useful in inter alia immunomodulation, butalthough a number of diseases are specified, use in immunosuppresion inneurodegeneration and MS are not listed.

Whilst most preferred groups R¹ to R³ for inclusion in the compound offormula I are simple saturated fatty acids or naturally occurring fattyacids with structural or metabolic function, such as medium chain orlong chain fatty acids, there are other possibilities. Particularlypreferred fatty acids are those that are utilised primarily by themetabolism for producing energy. Where fatty acids are structural, thatis utilised in membranes, they are conveniently such as γ-linolenicacid, linoleic acid, dihomo-γ-linolenic acid and arachidonic acidresidues. By residue is meant the moiety that remains after the fattyacid carboxyl group esterifies to one of the hydroxy groups of theglycerol molecule.

Other preferred acids for sn-1 and sn-3 are selected from fatty acidsthat are metabolised in the human to yield energy as opposed to a fattyacid that is primarily directed to the structural membrane pool: suchpreferred acids include oleic acid and palmitic acid.

Where the sn-1 and sn-3 fatty acid chain (R¹ and R³) is unsaturated itmay also be that of other essential fatty acids, such as the n-3 acidssuch as stearidonic acid, eicosapentanoic acid and docosahyexanoic acid.Where the fatty acid is optionally substituted these will preferably beby hydroxy, oxo, carboxyl, alkyl, alkenyl and alkoxy groups. Thehydrocarbyl chain is preferably one of from 1 to 30 carbon atoms inlength, more preferably from 4 to 28 carbon atoms in length, still morepreferably 4 to 24 carbon atoms in length. Most preferably thehydrocarbyl chain is that of a fatty acid, more particularly a mono orpolyunsaturated fatty acid.

Many of the preferred lipids for use in the method of the invention areknown and may be prepared by chemical process known in the art. Forexample, many are commercially available, such as trigamma-linolenin,known as TLG, but herein referred to as GGG, reflecting the identity ofgroups R¹R²R³ where G represents γ-linolenic acid residues.

GGG is commercially available from Nu-Check-Prep Inc. EP 0300844describes its synthesis using a base-catalysed trans-esterification oftriacetin with methyl gamma linolenate to give a mixture containing 80%GGG, unreacted methyl γ-linolenate and 10% mono- and di-glycerides.

Triarachidin is known and small quantities can be obtained commerciallyeg. from Sigma AAA has been synthesised from arachidonic acid by usingimmobilised lipase patented for angiogenisis-enhancing activity U.S.Pat. No. 4,888,324.

However, whilst the tri and di-γ-linolenic acid, dihomo-γ-linolenic acidor arachidonic acid di or triglycerides may be used, the presentinventors prefer the use of the mono-γ-linolenic acid,dihomo-γ-linolenic acid or arachidonic acid sn-2 ester triglyceridesbecause they administer less of the immunomodulatory and proinflammatoryfatty acids γ-linolenic acid, dihomo-γ-linolenic acid or arachidonicacid whilst retaining the enhanced activity that the sn-2 γ-linolenicacid, dihomo-γ-linolenic acid or arachidonic acid moiety provides withregard to the desired membrane noinialising and disease modifyingeffect.

Novel lipids which are preferred are accessible by processes and methodsset out in the Examples herein. Most preferred lipids are those wherethere is just a single γ-linolenic acid, dihomo-γ-linolenic acid orarachidonic acid moiety esterified to the glycerol at sn-2, with theflanking sn-1 and sn-3 acids being unsaturated medium chain or longchain acids.

Thus a further aspect of the present invention provides novel lipidsdisclosed herein including compounds of formula II

wherein R¹ and R³ are the same and are —C(O)(CH₂)_(n)CH₃ wherein n isselected from 4 to 14, more preferably 6 to 10 and most preferably 7, 8or 9 and R² is selected from γ-linolenyl, dihomo-γ-linolenyl andarachidonyl.

A further aspect of the present invention provides a method forsynthesis of a compound of general formula III

wherein R¹ and R³ are the same and are —C(O)(CH₂)_(n)CH₃ wherein n isselected from 4 to 14, more preferably 6 to 10 and most preferably 7, 8or 9 and R² is γ-linolenyl residue, dihomo-γ-linolenyl residue orarachidonyl residue comprising

reacting 1,3-dihydroxyacetone with a compound of formulaX—C(O)(CH₂)_(n)CH₃ wherein X is selected from Cl, Br and I,to give the corresponding 1,3 -di-(C(O)(CH₂)_(n)CH₃) 2-keto compoundreducing the keto group to the corresponding 1,3-di-(C(O)(CH₂)_(n)CH₃)2-oland reacting that with γ-linolenyl chloride or dihomo-γ-linolenylchloride or arachidonyl chloride.

A still further aspect of the present invention provides a method forsynthesis of a compound of general formula IV

wherein R¹ to R³ are the same and selected from γ-linolenyl residue,dihomo-γ-linolenyl residue or arachidonyl residue

comprising reacting the corresponding γ-linolenyl chloride,dihomo-γ-linolenyl chloride or arachidonyl chloride with glycerol.

Synthesis of some of these compounds is described below and schemesshown in the figures below.

For example, a single-step esterification of glycerol using GLA and acoupling agent, such as DCCI/DMAP(1.1-Dicyclocohexylcarbodiimide/4-dimethylaminopyridine) couplingreagents may be carried out. This method gives a good yield butgenerates impurities that, unless removed, make the final oil cloudy.This may be circumvented by using a coupling agent such as EDCI(1-(3-dimethylaminopropyl)-3-ethylcarbodiimide hydrochloride) whichgives rise to water-soluble by-products that are easier to remove. Jpn.Kokai Tokkyo Koho JP 05310638 A2 22Nov. 1993 Heisei, 6 pp. describes thepreparation of tri-α-linolenin (LnLnLn where Ln is linoleic acid) usingDCCI, and analogous but different reaction.

A alternative approach provides a two-step sequence that utilisesreaction of GLA-Cl (prepared from γ-linolenic acid and oxalyl chloride)and glycerol in dichloromethane/pyridine with good yields at scale-up to250 g purified by column chromatography. Jpn. Kokai Tokkyo Koho JP04328199 A2 17 Nov. 1992 Heisei, 5 pp. (Japan) Concentration ofa-linolenic acid triglyceride by flash chromatography. Ando, Yukiki,Watanebe, Yoichi, Takagi, Yoshiaki (Nisshin Oil Mills Ltd, Japan)describes a related but different technique for purification oftri-α-linolenin (LnLnLn).

Comparative example tricaprin (glycerol tridecanate) is a known compoundcommercially available from Sigma. It has been prepared by reaction ofmethyl decanoate and sodium glyceroxide with subsequent purification ofthe crude product by column chromatography (see E. S. Lutton and A. J.Fehl, Lipids, 5, 90-99 (1970))

An alternative method involves the acid-catalysed reaction of glycerolwith decanoic acid followed by four crystallisations (see L. H. Jensonand A. J. Mabis, Acta Cryst., 21, 770 (1966)).

The applicant further provides an improved process which allows glycerolto react with more than 3 equivalents of decanoyl chloride and purifiedthe tricaprin product by recrystallisation.

Further aspects of the present invention provide use of triglycerideoils as described above for the manufacture of a medicament for thetreatment of neurodegenerative diseases as set out for the method of theinvention. Particularly preferred medicaments are for the arresting andreversing of neurodegeneration in multiple sclerosis of all types butparticularly relapsing remitting, primary progressive and chronicprogressive and the restoration, in part or completely, of neuronalintegrity function such as measured, eg. By MRI or CAT scan or by EDSSscore. Other TGF-β1 responsive diseases may be treated as set outpreviously.

The lipids for use in the present invention may be administered by anyof the conventional vehicles known in pharmacy. Most conveniently theyare administered as neat oils or in admixture with foodstuffs, in theform of capsules containing such oils, or in enterically coated forms.Other forms will occur to those skilled in the art but RemingtonPharmaceutical Sciences 19^(th) Edition.

It will be realised by those skilled in the art that other beneficialagents may be combined with the lipids for use in the present inventionor otherwise form part of a treatment regime with the lipids. Thesemight be ion channel blockers, eg. sodium channel blockers, interferons(α, β, or γ), T-cell depleters, steroids or other palliative agents. Itwill further be realsied that where the immune and inflammatoryresponses are being modulated, such combinations will need to be madecarefully, given the complex nature of these systems. However, given thedelayed response to the present oils, shorter acting agents might bebeneficial in the first months of treatment before the TGF-β1 levels arenormalised, as long as the additional treatment does not impede thisnormalization process.

The synthesis of structured lipids for use in the present invention isdescribed below together with synthesis of comparative examples. Some ofthese lipids are novel while others are known but have not been used forthe treatment of the invention.

The present invention will now be described by way of Example only byreference to the following non-limiting Tables, Examples and Figures.Further embodiments falling within the scope of the invention will occurto those skilled in the art in the light of these.

Tables

Table 1: Shows the compositional % Total fatty acid content of varioustriglyceride oils and protective effect in EAE.Table 2: Shows the parameters of the three treatment groups in high sn-2GLA Borage Oil trial described in PCT/GB04/002089.Table 3: Shows the effect of various forms of GLA on EAE incidence andclinical score in SJL mice: lower score indicating improved therapeuticeffect.Table 4: Shows the failure of enriched Blackcurrent oil, a high GLA, butlow sn-2-GLA, plant oil, to match fungal and Borage oils in EAE.

FIGURES

FIG. 1: Shows spontaneous peripheral blood mononuclear cell cytokineproduction in placebo and high sn-2 γ-linolenic acid, PCT/GB04/002089trial oil treated human MS patients at 18 months.

FIG. 2: Shows the effect of placebo and low dose (5 g/day) high sn-2 GLABorage oil on human MS patient EDSS score as compared to high dose (15g/day) displayed as a histogram with months treatment on the x axis.

FIG. 3: Shows the effect of placebo, low dose and high dose high sn-2GLA Borage oil on human MS patient Mean Relapse rate (%) as histogramwith months on x axis.

FIG. 4: Shows the reaction scheme for synthesis of a single fatty acidtriacylglyceride for use in the method and use of this invention.

FIG. 5: Shows the reaction scheme for synthesis of control compoundtricaprin.

FIG. 6: Shows the reaction scheme for synthesis of CGC, a mixed fattyacid triacylglyceride of the invention.

FIG. 7: Shows the reaction scheme for synthesis of C-DHGLA-C, a mixedfatty acid triacylglyceride of the invention.

FIG. 8: Shows the reaction scheme for synthesis of control compound GCG,1,3-dicapryl, 2-γ-linolenic acid.

FIG. 9: Shows the reaction scheme for synthesis of C-AA-C, a mixed fattyacid traiacylglyceride of the invention.

FIGS. 10 to 19 show the results of EAE studies in SJL and C57BL mice asset out in the examples below. (DHLA=DHGLA: A=AA)

EXAMPLES High Borage Oil (PCT/GB04/002089) Trial.

Twenty-eight active relapsing-remitting (two relapses in the preceding18 months) multiple sclerosis patients (ages ranging from 18 to 65 yrs)were entered into a double-blind placebo controlled trial to investigatethe effects of encapsulated borage oil on clinical activity andlaboratory parameters over 18 months. This oil was of high sn-2 (GLA)content (>40% of sn-2 residues being γ-linolenic acid) with low monene(eg. erusic acid) content and had no added Vitamin E, a knownimmunomodulator.

Patients were recruited from neurology out-patient clinics at two innercity hospitals; hospital informed consent was obtained on first(baseline) visit. Exclusion criteria include any form of steroid orimmunosuppressive drug treatment, pregnancy, hyperlipidemia, regular useof aspirin or related drugs and vitamin or fatty acid supplementationwithin the previous three months.

Only patients meeting all the following criteria were included in thetrial: (a) able to provide informed consent prior to treatment, with thefull understanding that consent may be withdrawn at any time withoutprejudice; (b) male or female out-patients aged 18 to 60 yearsinclusive; (c) have confirmed diagnosis of clinically definite relapsingMS; (d) have had at least three documented clinical relapses in the pasttwo years; (e) have a baseline Expanded Disability Scoring Scale (EDSS)score of 0.0-5.5 inclusive, provided they have well documentedexacerbations; and (f) healthy, apart from the MS-related symptoms, asconfirmed by the medical history, physical examination and clinicalchemistry, urine and haematological tests,

Patients were randomly allocated by the Pharmacy Department to one ofthree groups each containing 12 patients:

-   -   One clinical group (n=12) to receive placebo (5 g of        Polyethylene Glycol 400)    -   Second clinical group (n=12) to receive low-dose (5 g) refined        Borage officinalis    -   Third clinical group (n=12) to receive high-dose (15 g) refined        Borage officinalis

Supplementation was in the form of one gram oil capsules daily (5/dayfor low dose, 15/day high dose) for 18 months duration. Borageofficinalis oil and omega-6 polyunsaturated fatty acids are foodingredients that are generally recognised as safe for human consumption(GRAS). There are no classification or labelling requirements under ECregulations. Clinical assessment included: Extended Disability ScaleScores (EDSS) and clinical relapse record. Venous blood (50 mis) wasobtained for laboratory studies on the 1^(st), 3^(rd), 6^(th), 12^(th),15^(th), and 18^(th) month of supplementation.

The following biochemical and immunological parameters were investigatedon each visit for comparison with pre-treatment data and between groupdata:

-   -   Stimulated and unstimulated ex vivo peripheral blood mononuclear        cell cytokine production: changes in TGF-β1, IFN-γ, TNF-α,        IL-1β, IL-6 and IFN-β, which are implicated in the pathogenesis        of MS. Cytokine and related gene expression.    -   Soluble adhesion molecules in serum particularly ICAM-1 and        VCAM-1    -   Peripheral blood mononuclear cell membrane fatty acids and        plasma phospholipid fatty acid composition.        Results are shown in Tables 1 and 2 and FIGS. 1 to 5.

The primary outcome parameter was the number of clinical relapsesbetween baseline (Month 0) and the end of treatment (Month 18).Secondary outcome parameters included: the time to first clinicalrelapse; severity of relapses, as assessed by EDSS score and the use ofsteroid treatment; and changes in EDSS at Month 3, 6, 9, 12, and 18compared to baseline and defined as at least 1.0 point increase in theEDSS that is sustained for 3 months or at least 1.5 point increase onthe EDSS from the baseline EDSS that is sustained for 3 months.

Eleven patients were in the placebo group, seven patients had beentaking low-dose Borage oil, and ten patients had been taking high-doseBorage oil. The study drug was well-tolerated, and there were no seriousadverse events during the 18-month trial.

Isolation and Culture of PBMC

Heparinised whole blood was diluted with an equal volume of Hanks'balanced salt solution (Sigma, UK) and the resulting diluted bloodlayered onto Lymphoprep (Nycomed, Oslo, Norway). Following densitycentrifugation at 800 g for 30 minutes the PBMC were removed from theinterface and diluted in Flanks' solution. The cells were then washedtwice by centrifugation for 10 minutes at 250 g. The resulting finalpellet was then resuspended in culture medium consisting of RPMI-1640medium (Sigma, UK) supplemented with 2 mM L-glutamine, 100U penicillinand 100 μg streptomycin (Sigma, UK) and 10% autologous plasma. 2×10⁶ perml PBMC, >95% viable as judged by trypan blue exclusion, were added totissue culture tubes (Bibby Sterilin Ltd, Stone, UK) and incubated for24h at 37° C. with 5% CO₂. The concentration of antigen, cell densityand time of culture were all determined in previous kinetic experimentsto determine maximum cytokine production (data not shown). Routinecytospin preparations were also prepared for subsequent differentialcounts. Following incubation the cells were removed from culture bycentrifugation at 250 g for 10 minutes, the resulting supernatants werethen removed, aliquoted and stored at −70° C.

Preparation of Plasma Samples

10 ml of heparinised blood was spun at 250 g for 10 minutes. Theresulting plasma layer was then removed, aliquoted and stored at −70° C.

Detection of Pro-Inflammatory Cytokines

TNF-α, IL-1β and IFN-γ in cell culture supernatants and plasma weredetected using commercially available paired antibodies enablingcytokine detection in an ELISA format (R&D systems Ltd, Abingdon, UK).The sensitivities for the TNF-α and IFN-γ ELISAs were 15.6-1000 pg/mland 3.9-250 pg/ml for IL-1β.

Detection of Biologically Active TGF-β1

Biologically active TGF-β1 in cell culture supernatants and plasma weredetected using the commercially available E_(max) ELISA system with asensitivity of 15.6-1000 pg/ml (Promega, Southampton, UK).

Statistical Analysis

Differences in cytokine production were compared using Student's t-testand Maim-Whitney U-test and were considered significant when p valueswere less than 0.05.

Results

Two patients had developed diarrhoea, both of whom were later confirmedto have been taking high-dose Borage oil. The diarrhoea was mild in onepatient, but was moderately severe in the second patient, who laterdiscontinued the study drug. The code was not broken and the diarrhoeahad stopped after the discontinuation of the drug, but reappeared uponre-challenge. Therefore, this patient was withdrawn from the trial. Theremaining patients who were treated with high-dose Borage oil showedexcellent clinical improvement on all primary and secondary outcomecriteria. For example, their mean EDSS score after 6 months of treatmenthad improved from baseline EDSS (FIG. 1). More importantly, the meannumber of clinical relapses had significantly reduced after 6 months oftreatment when compared to the number of relapses in the placebo group(FIG. 2). In contrast, patients who had been receiving low-dose Borageoil did not show any clinical improvement when compared to the placebogroup. In addition to its beneficial effect on MS disease activity, highdose Borage oil provided some symptomatic relief of muscle spasticity(stiffness) and painful sensory symptoms, and also improved cognitivefunctions.

As can be seen for the figures below, relapse rate after 9, 12 and 18months was down to zero in the high dose group. The increase seen at 15months was due to the patient dropping out of this group.

The following are three brief case histories to illustrate thetherapeutic benefits of high dose high sn-2 GLA Borage oil. The firsttwo are from the trial while the third is a post trial patient for whomMRI studies were obtained.

Patient 1 (Treatment):

The first patient was a 48 year old woman who had had a clinicallyactive, relapsing remitting MS for 9 years. She had originally worked asa full-time administrator at the local Health Authority, but she wasunable to perform her duties because of her severe MS. Therefore, shelater worked as a part-time secretary, but still had difficulties inmobilization because of muscles stiffness and sensory disturbances. Shewas also experiencing severe clinical relapses at an average of onerelapse every nine months. Most of these relapses had resulted inhospital admissions for steroid therapy. In view of her active MS, shewas recruited into the Borage oil trial. There were no adverse eventsrelating to the study, and after taking the medication for four months,she experienced good improvement in her walking and sensory symptoms.

About nine months after therapy, she was well enough to start full-timeemployment. In addition, she remained relapse-free for the 18-monthduration of the clinical trial. Following the conclusion of the trial,the treatment code revealed that she was taking high-dose Borage oil.

Patient 2 (Control):

The second case was a 46-year old woman who also had a clinically activerelapsing remitting MS for 8 years. She had originally worked as a shopassistant, but became unemployed after MS was diagnosed.

Her symptoms included difficulty with mobilisation and painful sensorysymptoms in both legs. She had experienced three clinical relapses inthe two years preceding the clinical trial, and had been admitted tohospital twice for steroid therapy. Consequently, she was recruited intothe Borage oil trial, but her walking continued to deteriorate. Sixmonths into the trial, she need to use a walking stick and also receivedtreatment with Baclofen to reduce low limb spasticity. Approximately tenmonths after starting the Borage oil trial, she was admitted to hospitalbecause of severe clinical relapse, which was treated with steroids. Shelater developed bladder disturbances and began to use a wheelchair forlong journeys. The treatment code was broken after the conclusion of the18-month trial, and she was found to have been taking placebo. Sincethen, she started using a walking frame for journeys exceeding 50 yards.

Patient 3: Treatment (Additional to Trial)

The third case was a 26 year-old man who was diagnosed with definite MSin April 2001. His symptoms had started in 1999 when he complained ofdiffuse, intractable pain affecting various parts of his body,particularly the left side of the chest and abdomen. This was followedby intermittent numbness in the hands and feet, associated withfluctuating weakness. There were also distressing bladder symptoms inthe form of urinary frequency and urgency. The diagnosis of MS in 2001was based on his relapsing remitting symptoms, and was confirmed bypositive cerebrospinal fluid analysis and magnetic resonance imaging(MRI) of the brain, which showed multiple white matter abnormalities inboth cerebral hemispheres. Symptoms did not respond to variouspharmaceutical therapies.

In April 2003, oral supplementation with the present high dose Borageoil was commenced. The patient reported dramatic improvement in hissymptoms within three months of starting this oral supplementation. Hispainful sensory symptoms disappeared completely. He reported no numbnessor weakness since May 2003, and noticed significant improvement in hisbladder control. The oral supplementation caused no adverse events. Arepeat brain MRI was undertaken to verify the reported improvement in MrN's symptoms. The repeat MRI showed a reduction in the size anddistribution of the white matter abnormalities.

EXAMPLES Structured sn-2 Lipids

In all the examples below higher purity is obtained by use of higherpurity starting material γ-linolenic, dihomo-γ-linolenic or arachidonicacid, such as is available eg from Sigma Aldrich. GLA 95 indicates 95%pure γ-linolenic acid.

Synthesis Example 1 synthesis of Trigammalinolenin 1) Acid ChlorideMethod

2.0 g (7.2 mmol, 3.1 equiv) GLA95 (95% pure γ-linolenic acid) wasdissolved in 10 ml DCM. 1.01 g (0.71 ml, 8.0 mmol, 3.4 equiv) oxalylchloride in 5 ml DCM added dropwise over 2-3 min under nitrogen. Stirredat RT overnight. Reaction mixture concentrated in vacuo to remove DCMand excess oxalyl chloride. This acid chloride was then added dropwiseover 2-3 min to a stirred mixture of 215 mg (2.3 mmol, 1 equiv) ofglycerol, 0.58 ml (3.1 equiv) pyridine and 10 ml DCM wider nitrogen. Themixture was stirred at RT overnight. The pyridine hydrochloride formedwas then filtered off and washed with DCM. The solution was washed 1×4ml water, 0.1N HCl, 5% sodium bicarbonate and 5% NaCl. Dried overmagnesium sulphate, filtered and concentrated in vacuo to a yellow oil.This oil was purified on a silica column using 10% ether in hexane aseluting solvent. A clear colourless oil was obtained, a sample of whichwas trans-esterified and subsequently analysed by GC. The productcontained 96.3% GLA

2) DCCI Method

2.19 g GLA95 (3.15 equiv), 230 mg (1 equiv) glycerol, 153 mg DMAP (0.5equiv) were stirred in 10 ml DCM under nitrogen. 1.85 g DCCI (3.6 equiv)in 5 ml DCM was added. The reaction mixture was stirred at RT undernitrogen overnight. The DCU formed was filtered and washed with DCM. DCMwashed 1×5 mls N HCl, water, 5% sodium bicarbonate and water. Dried overmagnesium sulphate, filtered and concentrated in vacuo to an oil. Thisoil was then purified on a silica column using 10% ether in hexane aseluting solvent. 1.47 g (67%) of a slightly cloudy oil was obtained. Asample of this product was trans-esterified and subjected to GCanalysis. The product contained 95.8% GLA.

Scale-Up

20 g (0.072 mol, 3.1 equiv) of GLA95 (gamma linolenic acid, 95%) wasdissolved in 100 ml DCM. 13.7 g (9.3 ml, 0.11 mol, 4.78 equiv) oxalylchloride was added over 3-4 min under nitrogen. The reaction mixture wasstirred under nitrogen overnight. It was then concentrated in vacuo toremove DCM and excess oxalyl chloride. This oil was then added dropwiseover ca 5 min to a stirred mixture of 2.14 g (0.023 mol, 1 equiv) ofglycerol, 100 ml DCM and 5.8 ml (5.68 g, 0.072 mol, 3.1 equiv) ofpyridine under nitrogen. 85 mg (0.7 mmol, 0.03 equiv) of DMAP(4-dimethylaminopyridine) catalyst was added. The mixture was stirred atRT overnight. Pyridine hydrochloride was filtered off and washed withDCM. The DCM solution was washed 1×25 ml: water, 10% sodium bicarbonate,0.1N HCl, 5% NaCl. (Emulsions formed during this process, especially atfirst). The DCM was dried over magnesium sulphate, filtered andconcentrated in vacuo to a brown oil (−21 g).

The oil was purified on a silica column using 5% ether in hexane atfirst and then 10%. 15.6 g (77% yield) of a clear oil was obtained. Bytic this material contained a small amount of free GLA. (This materialwas repurified at a later date)

Large Scale-Up

The above reaction was repeated on 10 times scale. Thus, 200 g of GLA95,1L DCM, 137 g of oxalyl chloride, and 21.4 g of glycerol were used. Onthe addition of the acid chloride the reaction mixture was cooled in acold water bath and the temperature kept below 35° C. 250 g of a brownoil were produced. This was initially purified on a 500 gram silicacolumn. The oil was dissolved in 200 ml hexane and applied to thecolumn. The column was eluted at first with hexane, then 5% ether inhexane and then 10%. Fractions were collected and analysed by ticeventually yielding two batches of oils. The first A (66 g) contained asmall amount of front running impurity and a little GLA (slower runningthan TGL), the second fraction B (99 g) was clear of front runningimpurity and contained a little GLA.

The large scale reaction was repeated using 169 g of GLA and gave twofractions as above. This time there was 85 g of ‘A’ fraction and 54 g of‘B’ fraction. Both batches of ‘A’ were combined and re-purified on a 500g silica column. The ‘B’ fractions were treated in a similar manner (15g of material from the small-scale reaction were also added to thisbatch).

Some fractions from the above were again re-purified to eventually give259 grams of oil. The oil was pumped down on a rotary evaporator underhigh vacuum to constant weight—256 g. This represents an overall yieldof 65%.

Analysis of Product. GC

A small sample was trans-esterified and subjected to GC analysis:

The GLA content was 97.1%. The main impurity was linoleic acid—1.91%.

Note: The original GLA95 that was used for the synthesis contained 96.2%GLA and 2.42% linoleic acid.

HPLC

An HPLC method was developed using a reversed phase column (Hypersil C184.6×100 mm), eluting with 80/20 acetonitrile/THF. Detection was by UV at210 nm. This showed the product to be a mixture of three components. Themain peak (93.6%) was the required product. A slower running impurity(representing 5.0% of the product) was probably a GGLI triglyceride(L1=linoleic acid). A second impurity was slightly faster running andrepresented 1.4% of the product.

Note: Absorption at 210 nm varies considerably between triglycerides ofdiffering fatty acid content. For example trigammalinolenin has a UVabsorbtion 5-6 times greater than that of trilinolenin

SUMMARY

254 g of glycerol tri-6,9,12-linolenate (gamma linolenic acidtriglyceride, trigammalinolenin, GGG) was prepared from 96.2% GLA by atwo-step acid chloride route. It is a clear, pale yellow oil and wasstored under nitrogen in the freezer. The GLA content was 97.1% and noC20:1, C22:1, or C24:1 acids were detected). The HPLC purity was 93.6%.Synthesis of higher purity GGG would is readily achievable using GLA 98(98% γ-linolenic acid: Scotia) or higher starting material.Comparative Lipid 1: Synthesis Tricaprin (Glycerol tridecanoate)

Small Scale

Glycerol (3.0 g, 0.0325 mol, 1 eq) pyridine (8.1 ml, 0.10 mol, 3.1 eq)and dichloromethane (100 ml) were stirred at room temperature undernitrogen. Decanoyl chloride (21 ml, 19.25 g, 0.10 mol, 3.1 equiv) wasthen added dropwise over 5 min, with external cooling in a water bath tokeep the temperature at 30-35 ° C. When the addition was complete4-dimethylaminopyridine (DMAP (0.12 g, 1 mmol, 0.03 eq) was added andthe mixture stirred under nitrogen at room temperature overnight. Theprecipitated pyridine hydrochloride was removed by filtration and washedwith dichloromethane. The combined washing and filtrate was then washedwith aqueous solutions (20 ml) of 5% sodium chloride, 5% sodiumbicarbonate, 0.1N hydrochloric acid, and 5% sodium chloride. Thedichloromethane layer was then dried over MgSO₄. and the solvent removedin vacuo. The residual oil crystallised on standing. This material wasrecrystallised from isopropanol (40 ml) to give 15.6 g (86% yield) of awaxy white solid.

Analysis

GC—99.8% pure

HPLC

(C18 4.6×100 mm, ACN/THF 85/15 1 ml/min, λ 210 nm)—94.9% pure

Large Scale

The above was repeated on 15 times the scale. Glycerol (45.0 g, 0.49mol, 1 eq), pyridine (121.5 ml, 1.50 mol, 3.1 eq) and dichloromethane(1.5 L) were stirred at room temperature under nitrogen. Decanoylchloride (315 ml, 288.8 g, 1.50 mol, 3.1 equiv) was then added dropwiseover 15 min, with external cooling in a water bath to keep thetemperature at 30-35 ° C. When the addition was complete4-dimethylaminopyridine (DMAP (1.8 g, 15 mmol, 0.03 eq) was added andthe mixture stirred under nitrogen at room temperature overnight. Theprecipitated pyridine hydrochloride was removed by filtration and washedwith dichloromethane. The combined washing and filtrate was then washedwith aqueous solutions (300 ml) of 5% sodium chloride, 5% sodiumbicarbonate, 0.1N hydrochloric acid, and 5% sodium chloride. Thedichloromethane layer was then dried over MgSO₄ and the solvent removedin vacuo. The residual oil crystallised on standing. This material wasrecrystallised from isopropanol (400 ml) to give 228 g (86% yield) of awaxy white solid.

Analysis

GC—99.8% pure

HPLC

(C18 4.6×100 mm, ACN/THF 85/15 1 ml/min, λ 210 nm)—94.9% pure

A further batch was made and combined with the small-scale batch aboveand recrystallised from isopropanol to give 44 g of product. The abovebatches were combined (268 g) and reanalysed:

GC

99.9% pure

HPLC

97.9%

SUMMARY

263 g of glycerol tridecanoate (tricaprin, CCC) was been prepared fromdecanoyl chloride (98%) by a one-step process (scheme given below). Itis a white, low-melting solid and was stored under nitrogen in thefreezer. The C content was 99.9% of fatty acid content and the HPLCpurity was 97.9%.

Synthesis Example 2 1,3-Dicaprin 2-gammalinolenoate (Glycerol1,3-didecanoate 2-octadecatri(6-Z,9-Z,12-Z)enoate or CGC)

This triglyceride is novel. Unlike CGC, its isomer CLnC (Ln=α-linolenicacid), has been identified (see K. Long et al Biotechnol. Lett., 20,369-372 (1998). and H. Mu, P. Kalo et al, Eur. J. Lipid Sci. Technol.,102, 202-211(2000). as a component of coconut oil. In addition, CLxC(Lx=a linolenic acid of unspecified double bond position) has beendescribed (see J. Gresti et al. J. Daily Sci., 76, 1850-1869 (1993)),

The two intermediates used in the synthesis of CGC are known (see L. ElKihel et al Arzneim-Forsch./Drug Res., 46, 1040-1044 (1996) and U.S.Pat. No. 4,178,299. The last step described below is novel and the firsttwo stages are also inventive since they are more suitable for largescale production than those previously reported.

CGC was prepared by reaction of 1,3-Dicaprin with GLA-chloride indichloromethane-pyridine. 1,3-Dicaprin was prepared by sodiumborohydride reduction of 1,3-didecanoyloxypropan-2-one, which was inturn prepared by reaction of decanoyl chloride with1,3-dihydroxyacetone. The intermediate 1,3-dicaprin must be handled withcare since it can undergo acyl migration on exposure to acids, bases andheat. An older method of making 1,3-dicaprin has been described (see A.P. J. Marek et al Chem. Physics Lipids, 16, 107-114 (1976).

A versatile, flexible synthesis of 1,3-diglycerides and triglycerides.by catalysed addition of decanoic acid to a glycidol ester (fromepichlorohydrin) is less attractive because of more severe reactionconditions and acyl migration problems. The final product, CGC, waspurified by careful column chromatography on silica which removedby-products.

Small Scale

1,3-didecanoyloxypropan-2-one

Decanoyl chloride (40.0 ml, 36.8 g, 0.19 mol, 1.98 equiv) was addeddropwise over 10-15 min to a stirred suspension of 1,3-dihydroxyacetonedimer (8.68 g, 0.048 mol, 1.0 equiv), pyridine (15.6 ml, 0.19 mol),4-dimethylaminopyridine (0.18 g, 0.0014 mol, 0.03 equiv) anddichloromethane (DCM, 150 ml) at room temperature under nitrogen. Thetemperature of the reaction mixture was kept below 30° C. by cooling ina cold water bath. The reaction mixture was stirred at RT under nitrogenovernight. The pyridine hydrochloride formed was removed by filtrationand washed with DCM. The combined filtrate and washings were then washedwith 1×25 ml portions of 5% NaCl, 5% NaHCO₃, 0.1N HCl, 5% NaCl. Thesolution was then dried over MgSO₄ and concentrated in vacuo to ayellowish semi-solid. This was then crystallised from methanol (150 ml)to give a white solid. The yield was 28.2 g (73%).

1,3-Dicaprin

The above ketone (28.2 g, 0.071 mol) was dissolved in tetrahydrofuran(THF, 200 ml). Water (10 ml) was then added, the solution cooled to 5°C., and sodium borohydride (5.38 g, 0.14 mol) added portionwise below10° C. The reaction mixture was stirred at RT for lh and thenconcentrated in vacuo to remove THF. The residue was partitioned betweenethyl acetate and 5% sodium chloride solution. The aqueous phase wasre-extracted with ethyl acetate and the combined extracts dried overMgSO₄ and concentrated in vacuo to a waxy solid. This was crystallisedtwice from hexane to give 11.2 g (40%) of a white solid. (99%+pure byHPLC)

1,3-Dicaprin 2-gammalinolenoate (CGC)

Gamma-linolenic acid (GLA95, 8.34 g, 0.03 mol) was dissolved indichloromethane (DCM, 60 ml). The resulting solution was stirred at RTunder nitrogen and oxalyl chloride (3.9 ml, 5.67 g, 0.044 mol) addeddropwise over 5 mins. The mixture was stirred at RT overnight and thenconcentrated in vacua to remove DCM and excess oxalyl chloride. Theresidual oily acid chloride (GLA-Cl) was then added dropwise over 15 min(ice/water cooling) to a stirred solution of 1,3-dicaprin (11.2 g, 0.028mol), DCM (50 ml), pyridine (2.42 ml, 2.37 g, 0.03 mol) and4-dimethylaminopyridine (0.10 g, 0.0008 mol, 0.03 equiv) at 10-15° C.The temperature was maintained by ice-water cooling. The reactionmixture was stirred at RT under nitrogen overnight. Pyridinehydrochloride was removed by filtration and washed with DCM. Thecombined washing and filtrate was washed with 1×20 ml portions of 5%NaCl, 5% NaHCO₃, 0.1N HCl, 5% NaCl. The solution was then dried overMgSO₄ and the solvent removed in vacuo.The residual brown oil waspurified by column chromatography on silica. Elution with hexane andthen with 5% ether/hexane gave 10.3 g (56%) of a colourless oil. Thestructure was confirmed by ¹³C NMR and GLC. Purity determined by HPLC.

Large Scale

1,3-didecanoyloxypropan-2-one

Decanoyl chloride (272 ml, 250 g, 1.3 mol, 2 equiv) was added dropwiseover 10-15 min to a stirred suspension of 1,3-dihydroxyacetone dimer(59.1 g, 0.65 mol, 1.0 equiv), pyridine (106 ml, 103.7 g 1.3 mol),4-dimethylaminopyridine (2.38 g, 0.02 mol, 0.03 equiv) anddichloromethane (DCM, 750 ml) at room temperature under nitrogen. Thetemperature of the reaction mixture was kept below 30° C. by cooling ina cold water bath. The reaction mixture was stirred at RT under nitrogenovernight. The pyridine hydrochloride formed was removed by filtrationand washed with DCM. The combined filtrate and washings were then washedwith 1×150 ml portions of 5% NaCl, 5% NaHCO₃, 0.1N HCl, 5% NaCl. Thesolution was then dried over MgSO₄ and concentrated in vacuo to ayellowish semi-solid. This was then crystallised from methanol (500 ml)to give a white solid. The yield was 158 g (60%).

1,3-Dicaprin

The above ketone (158 g, 0.40 mol) was dissolved in tetrahydrofuran(THF, 2.25 L). Water (50 ml) was then added, the solution cooled to 5°C., and sodium borohydride (5.66 g, 1.5 eq) added portionwise below 10°C. The reaction mixture was monitored by HPLC (C18, eluted with ACN at 1ml/min λ210 nm) (Note: only about 4.5 g of the borohydride was in factadded, as all SM had reacted).The reaction mixture was stirred at RT for1h and then concentrated in vacuo to remove THF. The residue waspartitioned between ethyl acetate and 5% sodium chloride solution. Theaqueous phase was re-extracted with ethyl acetate and the combinedextracts dried over MgSO₄ and concentrated in vacuo to a waxy solid.This was crystallised twice from hexane to give 96 g (60%) of a whitesolid, (98% pure by HPLC)

1,3-Dicaprin 2-gammalinolenoate (CGC)

Gamma-linolenic acid (GLA95, 120.2 g, 0.43 mol) was dissolved indichloromethane (DCM, 750 ml). The resulting solution was stirred at RTunder nitrogen and oxalyl chloride (55.7 ml, 82.3 g, 0.65 mol, 1.5 eq)added dropwise at 15-20° C. over 15 mins. The mixture was stirred at RTovernight and then concentrated in vacuo to remove DCM and excess oxalylchloride. The residual oily acid chloride (GLA-Cl) was then addeddropwise over 30-40 min at 10-15° C. (ice/water cooling) to a stirredsolution of 1,3-dicaprin (164.7 g, 0.41 mol), DCM (650 ml), pyridine(33.3 ml, 32.5 g, 0.41 mol) and 4-dimethylaminopyridine (1.50 g, 0.012mol, 0.03 equiv) at 10-15° C. The reaction mixture was stirred at RTunder nitrogen overnight. Pyridine hydrochloride was removed byfiltration and washed with DCM. The combined washing and filtrate waswashed with 1×150 ml portions of 5% NaCl, 5% NaHCO₃, 0.1N HCl, 5% NaCl.The solution was then dried over MgSO₄ and the solvent removed in vacuoto a brown oil (275 g).

The scale of the above three reactions was the largest on which each wascarried out. The borohydride reduction produced, in addition to1,3-dicaprin, a by-product in variable yield. The presence of thisby-product greatly affected the yield of the isolated pure 1,3-dicaprin;the by-product could only be removed by two crystallisations of thecrude product. Since the final product, CGC, is purified by columnchromatography, it is imperative that the 1,3-dicaprin used for thefinal step is as pure as possible!

From the above reactions about 440 g of crude CGC was produced as abrown oil. This was purified on a series of silica columns using hexanefollowed by 2-3% ether/hexane. The purification required 7 or 8 columns,using 3-4 kilos of silica, 25-30 litres of solvent (recycling solventkept this figure low—in practice over 100 litres were used)

The resulting product, a clear almost colourless oil, (264 grams) was96.4% pure by HPLC (C18 4.6×100 mm, eluted with 85/15 ACN/THF at UVdetection λ210 nm). GC indicated a ratio of 66.1/33.9 C/G. NMR analysisindicated the product to have the correct CGC structure and be of atleast 95% purity: δ_(c) (500 MHz, CDCl₃) 172.65 (2-GLA carbonyl), 173.25(1,3-capric carbonyl). Ratio of signals 2.04:1. No signal at 173.0indicating absence of 1.3-GLA. Trace signal at 172.79 could be oleicacid impurity in GLA or 2-capric acid.

SUMMARY

264 g of glycerol 1,3-didecanoate-2-gammalinolenoate(1,3-dicaprin-2-GLA, CGC) has been prepared from decanoyl chloride (98%)by a three-step process (scheme given below). It is an almost colourlessoil (slight yellow tinge) and was stored under nitrogen in the freezer.The HPLC purity was 96.4%.

Synthesis Example 3 1,3-Didecanoate-2-dihomo-γ-linolenoate (Glycerol1,3-didecanoate2-eicosa-(8Z,11Z,14Z)-trienoate or C(DHLA)C

This triglyceride appears to be novel—no reference to it has been found.DHLA (3.93 g, 12.8 mmol, 1 eq) was dissolved in dichloromethane (DCM, 20ml) and stirred at room temperature under a nitrogen atmosphere. Oxalylchloride (1.69 ml, 2.46 g, 19.4 mmol, 1.5 eq) was added dropwise over1-2 min, and left stirring at room temperature overnight. The resultingsolution was concentrated in vacua to remove DCM and excess oxalylchloride. The residual oily acid chloride (DHLA-Cl) was then addeddropwise over 5 min at 25° C. to a stirred mixture of 1,3-dicaprin (4.91g, 12.2 mmol, 0.95 eq), pyridine (0.98 ml, 0.96 g 12.1 mmol, 0.95 eq)and 4-dimethylam inopyridine (DMAP, 8 mg, 0.07 mmol, 0.03 eq). Thereaction temperature rose to 32° C. during the addition. The reactionwas stirred at 30-35° C. and monitored by HPLC. The reaction was stoppedafter 1.5 h. The precipitated pyridine hydrochloride was filtered offand washed with DCM. The combined filtrate and washings were then washedwith 1×10 ml portions of 5% NaCl, 5% NaHCO₃, 0.1N HCl, 5% NaCl. Thesolution was then dried over MgSO₄ and concentrated in vacuo to give thecrude product as a yellow-orange oil (8.9 g, 86% purity by HPLC). Thisoil was chromatographed on silica gel (250 g). Elution with hexane anddiethyl ether-hexane (2-6%) gave a purified product as a pale yellowoil. Treatment of a hexane solution with decolourising charcoal andremoval of the solvent in vacuo gave C(DHLA)C as a clear colourless oil(6.48 g, 98.9% purity by HPLC).

Synthesis Example 4 Triarachidin (Glyceroltrieicosotetra5-Z,8-Z,11-1,14Z-eneoate) or AAA

Arachidonic acid (50.9 g, 0.17 mol, 3 eq) was dissolved indichloromethane (DCM, 175 ml) and stirred at room temperature under anitrogen atmosphere. Oxalyl Chloride (21.9 ml, 31.9 g, 0.25 mol, 4.4 eq)was then added to the stirred solution over 5 min and the temperatureincreased by 4° C. The resulting yellow-green mixture was stirred at RTovernight and then concentrated in vacuo to remove DCM and excess oxalylchloride. The residual oily acid chloride (A—Cl) was then addeddrop-wise over 15 min to a pre-warmed (25° C.) stirred mixture ofglycerol (5.11 g, 0.055 mol, 1 eq), pyridine (13.5 ml, 13.2 g, 0.17 mol,3 eq) and 4-dimethylamino pyridine (DMAP, 0.20 g, 0.002 mol, 0.03 eq).The temperature of the reaction mixture rose to 42° C. during theaddition and a gentle reflux was observed. The mixture was stirred at30-40° C. and monitored by HPLC. After 2 h, no further product formationwas observed. The precipitated pyridine hydrochloride was filtered offand washed with DCM. The combined filtrate and washings were then washedwith 1×50 ml portions of 5% NaCl, 5% NaHCO₃, 0.1N HCl, 5% NaCl. Thesolution was then dried over MgSO₄ and concentrated in vacuo to give thecrude product as a yellow-orange oil (57 g). This oil was purified bycolumn chromatography on silica gel (ca. 600 g). Elution with hexane anddiethyl ether(2-4%)-hexane gave 22.8 g of the product as an oil. Asecond batch (17.8 g) was produced from 39.8 g of arachidonic acid, Thetwo batches were combined and residual solvents removed under vacuo togive 40.5 g (43%) of a mobile pale yellow oil. HPLC purity 84.8% GLCanalysis 94.3% AA (arachidonic acid).

Comparative Lipid 2 1,3-Di(octadeca-6Z,9Z,12Z-enoyloxy)propan-2-one

(1,3-Di(γ-linolenoyloxy)propan-2one, GonG) Stage 1 Intermediate for GCG

Gamma-linolenic acid (GLA95, 197 g, 0.71 mol, 2.2 equiv) was dissolvedin dichloromethane (DCM, 600 ml) contained in a 2L 3 necked flask. Theresulting solution was stirred at RT under nitrogen. Oxalyl chloride (93ml, 136 g, 1.07 mol, 3.3 eq) was added dropwise at 15-20° C. over 15min. The brown mixture was stirred at RT overnight and then concentratedin vacuo to remove DCM and excess oxalyl chloride. The residual oilyacid chloride (GLA-Cl) was then added dropwise over 20 min at 25° C. toa stirred mixture of 1,3-dihydroxyacetone dimer (28.99 g, 0.32 mol, 1.0equiv), pyridine (52 ml, 50.9 g 0.64 mol, 2.0 equiv),4-dimethylaminopyridine (2.36 g, 0.02 mol, 0.06 equiv) anddichloromethane (DCM, 600 ml) at room temperature under nitrogen. Thetemperature of the reaction mixture was allowed to rise to 40° C. andthe mixture was stirred for a further 2 h under nitrogen (monitored byHPLC). The pyridine hydrochloride that foinied was removed by filtrationand washed with DCM. The combined filtrate and washings were then washedwith 1×150 ml portions of 5% NaCl, 5% NaHCO₃, 0.1N HCl, 5% NaCl. Thesolution was then dried over MgSO₄ and concentrated in vacuo to give ca.200 g of a yellow oil. This material was partially purified by columnchromatography on silica (600 g). Elution with hexane and thenether-hexane mixtures (2-15%) gave 42 g of a pale yellow oil. This oilwas chromatographed again on silica (600 g) and eluted with hexane andthen 1-10% ether-hexane to give the product (95.9% purity) as a paleyellow oil. The yield was 42 g (17%).

1,3-Di(octadeca-6Z,9Z,12Z-enoyloxy)propan-2-ol

(1,3-Di(γ-linolenoyloxy)propan-2-ol or 1,3-Di-gamma-linolenin GolG)Stage 2 Intermediate for GCG

13-Di(γ-linolenoyloxy)propan-2-one (GonG, 25.5 g, 0.04 mol, 1 eq) wasdissolved in tetrahydrofuran (THF, 375 ml) and water (12.7 ml). Thesolution was vigorously stirred at −20° C., care was taken to keep thereaction temperature below −15° C. Sodium borohydride (790 mg, 0.02 mol,1.25 eq) was added portionwise to the stirred solution over 3 mins. Thereaction mixture was stirred for a further 10 mins at −20° C. and hexane(380 ml) then added. The still cold mixture was then washed with water(2×200 ml), dried over MgSO₄ and concentrated in vacuo to give the titlecompound as a brown oil (27.8 g) (82.6% purity by HPLC, less than 1%migrated material). Another batch was prepared and combined with thefirst to give 50 g of crude product. This material was purified bycolumn chromatography on silica gel (400 g). Elution with hexane anddiethyl ether-hexane mixture (5-20%) gave 36.1 g of the product as apale oil (91.5% purity).

(N.B. Care should be taken not to leave the compound on the silicaovernight as it appears to undergo a migration reaction, giving GGoI)

1,3-Di-γ-linolenin 2-decanoate (Glycerol1,3-dioctadeca-(6Z,9Z,12Z)-trienoate 2-decanoate or GCG)

Decanoyl chloride (13.5 ml, 12.4 g, 0.065 mol, 1.1 eq) was added to astirred solution of 1,3-di-γ-linolenin (36.1 g, 0.059 mol, leq), drypyridine (5.7 ml, 5.6 g, 0.07 mol, 1.1 eq), 4-dimethylaminopyridine (0.2g, 0.002 mol, 0.03 eq) and dichloromethane (DCM, 150 ml) over ca. 10mins. The temperature was maintained at 17 ° C. −23 ° C. duringaddition. The reaction was then stirred at 30-35 ° C. and monitored byHPLC. A further 1-2 ml of decanoyl chloride was added after 1 h, 1.5 hand 2 h. Further addition appeared to increase the conversion to productas determined by HPLC. After 3 h the reaction mixture was filtered andthe filtrate washed with DCM. The combined filtrate and washings werethen washed with 1×50 ml portions of 5% NaCl, 5% NaHCO₃, 0.1N HCl, 5%NaCl. The DCM extract was then dried over MgSO₄ and concentrated invacuo to give the crude product as a pale yellow oil; (purity 90% byHPLC). The oil was purified by column chromatography on silica gel (600g). Elution with hexane and diethyl ether-hexane (1.5-2.5 then 3.5%)gave the product (GCG.) as a clear oil; (35.5 g 96.1% purity by HPLC).Another 7.5 g of pure lipid was obtained by further chromatography onsome of the fractions containing only a small amount of impurity.

Synthesis Example 5 1,3-Dicaprin 2-arachidonate (Glycerol1,3-didecanoate 2-eicosatetra-(5-Z,8-Z,11-Z,14-Z)enoate or CAC)

This triglyceride is known. CAC has been identified as a constituent oflymph lipids following administration of safflower oil to rats. WO 03013,497 describing an arachidonic acid containing triglyceride (producedby culturing Mortierella alpina) useful for diseases caused by brainhypofunction, but specifically for cognition enhancement. The twointermediates used in the synthesis of CAC are known.

The synthesis of CAC from 1,3-dicaprin, and the purification of this areall novel.

Here CAC was prepared by reaction of 1,3-Dicaprin with arachidonylchloride in dichloromethane-pyridine. 1,3-Dicaprin was prepared bysodium borohydride reduction of 1,3-didecanoyloxypropan-2-one, which wasin turn prepared by reaction of decanoyl chloride with1,3-dihydroxyacetone. The intermediate 1,3-dicaprin must be handled withcare since it can undergo acyl migration on exposure to acids, bases andheat. An older method ⁶ of making 1,3-dicaprin, by catalysed addition ofdecanoic acid to a glycidol ester (from epichlorohydrin) was deemed lessattractive because of more severe reaction conditions and acyl migrationproblems. The final product, CAC, was purified by careful columnchromatography on silica which removed by-products.

1,3-Dicaprin 2-arachidonate (CAC)

Arachidonic acid (AA96, 8.34 g, 0.03 mol) was dissolved indichloromethane (DCM, 60 ml). The resulting solution was stirred at RTunder nitrogen and oxalyl chloride (3.9 ml, 5.67 g, 0.044 mol) addeddropwise over 5 mins. The mixture was stirred at RT overnight and thenconcentrated in vacuo to remove DCM and excess oxalyl chloride. Theresidual oily acid chloride (GLA-Cl) was then added dropwise over 15 min(ice/water cooling) to a stirred solution of 1,3-dicaprin (11.2 g, 0.028mol), DCM (50 ml), pyridine (2.42 ml, 2.37 g, 0.03 mol) and4-dimethylaminopyridine (0.10 g, 0.0008 mol, 0.03 equiv) at 10-15° C.The temperature was maintained by ice-water cooling. The reactionmixture was stirred at RT under nitrogen overnight. Pyridinehydrochloride was removed by filtration and washed with DCM. Thecombined washing and filtrate was washed with 1×20 ml portions of 5%NaCl, 5% NaHCO₃, 0.1N HCl, 5% NaCl. The solution was then dried overMgSO₄ and the solvent removed in vacuo.The residual brown oil waspurified by column chromatography on silica. Elution with hexane andthen with 5% ether/hexane gave 10.3 g (56%) of a colourless oil. Thestructure was confhined by ¹³C NMR and GLC. Purity determined by HPLC.

Large Scale

1,3-didecanoyloxypropan-2-one

Decanoyl chloride (272 ml, 250 g, 1.3 mol, 2 equiv) was added dropwiseover 10-15 min to a stirred suspension of 1,3-dihydroxyacetone dimer(59.1 g, 0.65 mol, 1.0 equiv), pyridine (106 ml, 103.7 g 1.3 mol),4-dimethylaminopyridine (2.38 g, 0.02 mol, 0.03 equiv) anddichloromethane (DCM, 750 ml) at room temperature under nitrogen. Thetemperature of the reaction mixture was kept below 30° C. by cooling ina cold water bath. The reaction mixture was stirred at RT under nitrogenovernight. The pyridine hydrochloride foinied was removed by filtrationand washed with DCM. The combined filtrate and washings were then washedwith 1×150 ml portions of 5% NaCl, 5% NaHCO₃, 0.1N HCl, 5% NaCl. Thesolution was then dried over MgSO₄ and concentrated in vacuo to ayellowish semi-solid. This was then crystallised from methanol (500 ml)to give a white solid. The yield was 158 g (60%).

1,3-Dicaprin

The above ketone (158 g, 0.40 mol) was dissolved in tetrahydrofuran(THF, 2.25 L). Water (50 ml) was then added, the solution cooled to 5°C., and sodium borohydride (5.66 g, 1.5eq) added portionwise below 10°C. The reaction mixture was monitored by HPLC (C18, eluted with ACN at 1ml/min λ210 nm) (Note: only about 4.5 g of the borohydride was in factadded, as all SM had reacted).The reaction mixture was stirred at RT forlh and then concentrated in vacuo to remove THE The residue waspartitioned between ethyl acetate and 5% sodium chloride solution. Theaqueous phase was re-extracted with ethyl acetate and the combinedextracts dried over MgSO₄ and concentrated in vacua to a waxy solid.This was crystallised twice from hexane to give 96 g (60%) of a whitesolid. (98% pure by HPLC)

1,3-Dicaprin 2-arachidonate (CAC)

Arachidonic acid (AA96, 78.8 g, 0.26 mol) was dissolved indichloromethane (DCM, 425 ml). The resulting solution was stirred at RTunder nitrogen and oxalyl chloride (33.9 ml, 49.4 g, 0.39 mol, 1.5eq)added dropwise at 15-20° C. over 15 mins. The mixture was stirred at RTovernight and then concentrated in vacuo to remove DCM and excess oxalylchloride. The residual oily acid chloride (GLA-Cl) was then addeddropwise over 30-40 min at 10-15° C. (ice/water cooling) to a stirredsolution of 1,3-dicaprin (94.2 g, 0.24 mol), DCM (450 ml), pyridine(19.1 ml, 18.6 g, 0.24 mol) and 4-dimethylaminopyridine (1.72 1.50 g,0.014 mol, 0.06 equiv) at 10-15° C. The reaction mixture was stirred atRT under nitrogen overnight. Pyridine hydrochloride was removed byfiltration and washed with DCM. The combined washing and filtrate waswashed with 1×150 ml portions of 5% NaCl, 5% NaHCO₃, 0.1N HCl, 5% NaCl.The solution was then dried over MgSO₄ and the solvent removed in vacuoto a brown oil (171 g).

The scale of the above three reactions was the largest on which each wascarried out. The borohydride reduction produced, in addition to1,3-dicaprin, a by-product in variable yield. The presence of thisby-product greatly affected the yield of the isolated pure 1,3-dicaprin;the by-product could only be removed by two crystallisations of thecrude product. Since the final product, CAC, is purified by columnchromatography, it is imperative that the 1,3-dicamin used for the finalstep is as pure as possible!

412 g of crude CAC was produced as a brown oil from the above reactions.This material was purified on a series of silica columns using hexanefollowed by 1-3% ether/hexane. The purification required 7 or 8 columns,using 3-4 kilos of silica, and 100 litres of solvent.

The resulting product, a clear very pale yellow oil, (295 grams) was95.8% pure by HPLC (C18 4.6×100 mm, eluted with 85/15 ACN/THF at 1ml/min. UV detection λ210 nm). GC indicated a ratio of 66.3/32.1 C/A(1.6% impurity carried through from the 5% impurity in A).

SUMMARY

295 g of glycerol 1,3-didecanoate-2-arachidonate (1,3-dicaprin-2-AA,CAC) has been prepared from decanoyl chloride (98%) and Arachidonic acid(95%) by a three-step process (scheme given below). It is a very paleyellow oil and was stored under nitrogen in the freezer. The HPLC purityis 95.8%.

Synthesis Example 7 1,3-Dioleoin 2-gammalinolenoate (Glycerol1,3-dioctadeca-9Z-enoate 2-octadecatri(6-Z,9-Z,12-Z)enoate or OGO)

This triglyceride is known: a carbon-14 labelled version has beenprepared by normal chemical synthesis and the normal unlabelled form bybiochemical synthesis using lipases. OGO is not a major component ofborage oil but its isomer OOG is (9%). The two intermediates used in thesynthesis of CGC are known. The last step is novel.

The use of, the synthesis of from 1,3-dioleoin, and the purification ofCGC are all believed novel. In general triglycerides CXC are preferredover OXO on patent and cost of goods grounds.

OGO was here prepared by reaction of 1,3-Doleoin with GLA-chloride indichloromethane-pyridine. 1,3-Diolein was prepared by sodium borohydridereduction of 1,3-dioleoylpropan-2-one, which was in turn prepared byreaction of oleoyl chloride with 1,3-dihydroxyacetone. The intermediate1,3-dioleolin must be handled with care since it can undergo acylmigration on exposure to acids, bases and heat. Older methods ^(7,8) ofmaking 1,3-dioleoin, via mono-tritylglycerols or glycidyl esters wasdeemed less attractive because of more steps and acyl migrationproblems. The final product, OGO, was purified by careful columnchromatography on silica which removed by-products.

Small Scale

1,3-dioleoylpropan-2-one

155.1 g Oleic acid (155.1 g, 0.55 mol, 1.0 equiv, Croda 094 RV05192) wasdissolved in dichloromethane (DCM, 500 ml). The solution was stirred atroom temperature (RT) under nitrogen and 104.4 g (1.5eq 71 mls) oxalylchloride (104.4 g, 71.8 ml, 0.82 mol, 1.5 equiv) was added dropwise at15-20° C. over about 20 mins. The reaction mixture was stirred overnightat RT. The excess oxalyl chloride and DCM were removed in vacuo and theresidual oily acid chloride was added dropwise over 15-20 min to astirred suspension of 1,3-dihydroxyacetone dimer (22.5 g, 0.24 mol ofmonomer), pyridine (40.4 ml), 4-dimethylaminopyridine (1.83 g) anddichloromethane (DCM, 500 m1) at room temperature under nitrogen. Thetemperature of the reaction mixture was kept below 20° C. by cooling inan ice/water bath. The reaction mixture was stirred at RT under nitrogenovernight. The pyridine hydrochloride formed was removed by filtrationand washed with DCM. The combined filtrate and washings were then washedwith 1×150 ml portions of 5% NaCl, 5% NaHCO₃, 0.1N HCl, 5% NaCl. Thesolution was then dried over MgSO₄ and concentrated in vacuo to anorange/brown semi-solid. This was triturated in methanol and stored inthe fridge overnight. The solid deposited (90% pure by HPLC) was thencrystallised from diisopropyl ether (DIPE) and methanol to give 51.3 gof an off white solid which was 95% pure by HPLC. Furthercrystallisation from DIPE/methanol yielded 41 g (27%) of a 98% pureproduct.

1,3-Diolein

The above ketone (32.8 g, 0.053 mol) was dissolved in tetrahydrofuran(THF, 250 ml). Water (10 ml) was then added, the solution cooled to 5°C., and sodium borohydride added portionwise below 10° C. The reactionwas followed by HPLC (C18, ACN/THF 90/10 at 2 mls/min, λ210 nm) andafter all the starting ketone had reacted the addition of theborohydride was stopped (830 mg, 0.022 mol added). The mixture was thenconcentrated in vacuo to remove THF. The residue was partitioned betweenethyl acetate and water. The aqueous phase was re-extracted with ethylacetate and the combined extracts dried over MgSO₄ and concentrated invacuo to an oil (˜33 g) which solidified on cooling. The product (68%pure by HPLC) was crystallised from 100 ml hexane at −20° C. (in thefreezer) overnight This product (92% pure 21.1 g) was recrystallisedfrom hexane (50 ml) to give 18.28 g (56% yield) of a product 97.5% pureby HPLC.

1,3-Diolein 2-gammalinolenoate (0-G-0)

γ-Linolenic acid (GLA95, 41.2 g, 0.15 mol, 1.1 equiv) was dissolved indichloromethane (DCM, 250 ml). The resulting solution was stirred at RTunder nitrogen and oxalyl chloride (19.1 ml, 28.2 g, 0.22 mol, 1.65equiv) added dropwise over 5 mins. The mixture was stirred at RTovernight and then concentrated in vacuo to remove DCM and excess oxalylchloride. The residual oily acid chloride (GLA-Cl) was then addeddropwise over 15 min (ice/water cooling) to a stirred solution of1,3-diolein (83.5 g, 0.13 mol), DCM (250 ml), pyridine (10.9 ml, 10.6 g,0.14 mol) and 4-dimethylaminopyridine (0.49 g, 0.004 mol, 0.15 equiv) at10-15° C. The temperature was maintained by ice-water cooling. Thereaction mixture was stirred at RT under nitrogen overnight. Pyridinehydrochloride was removed by filtration and washed with DCM. Thecombined washing and filtrate was washed with 1×80 ml portions of 5%NaCl, 5% NaHCO₃, 0.1N HCl, 5% NaCl. The solution was then dried overMgSO₄ and the solvent removed in vacuo.The residual brown oil waspurified by column chromatography on silica. Elution with hexane andthen with 5% ether/hexane gave 63.6 g (54%) of a colourless oil. Puritydetermined by HPLC.

SUMMARY

64 g of glycerol 1,3-oleoate-2-gammalinolenoate (1,3-dioleate-2-GLA,OGO) was prepared from oleoyl chloride (98%) by a three-step process(scheme given below). It was an almost colourless oil (slight yellowtinge) and is being stored under nitrogen in the freezer. The HPLCpurity was 89.4%.¹³C NMR Data for Structured lipidsGGG δ_(C) (125.7 MHz, CDCl₃) 172.69 (1C, C-2 carbonyl), 173.09 (2C, C-1,C-3 carbonyls)CGC δ_(C) (125.7 MHz, CDCl₃) 172.76 (1C, C-2 carbonyl), 173.17 (2C, C-1,C-3 carbonyls)CAC δ_(C) (125.7 MHz, CDCl₃) 172.65 (1C, C-2 carbonyl), 173.28 (2C, C-1,C-3 carbonyls)C(DHLA)C δ_(C) (125.7 MHz, CDCl₃) 172.83 (1C, C-2 carbonyl), 173.30 (2C,C-1, C-3 carbonyls)GCG δ_(C) (125.7 MHz, CDCl₃) 172.91 (1C, C-2 carbonyl), 173.11 (2C, C-1,C-3 carbonyls)OGO δ_(C) (125.7 MHz, CDCl₃) 172.69 (1C, C-2 carbonyl), 173.25 (2C, C-1,C-3 carbonyls)AAA δ_(C) (125.7 MHz, CDCl₃) 172.66 (1C, C-2 carbonyl), 173.04 (2C, C-1,C-3 carbonyls)CCC δ_(C) (125.7 MHz, CDCl₃) 172.81 (1C, C-2 carbonyl), 173.21 (2C, C-1,C-3 carbonyls)

Experimental Procedure

The proton-decoupled ¹³C NMR spectra with suppressed NOE were collectedat 21° C. in a 5-mm broadband probe on a Joel 500 MHz spectrometeroperating at 125.728 MHz. Waltz decoupling was the chosen mode ofdecoupling and was gated on only during the 14.89s acquisition time. Therelaxation delay was set at 30 secs and the pulse angle was 90°. Thespectral window used was ca. 35 ppm (from 173.5 to 172.6 ppm) with a 170ppm offset. The spectra were internally referenced to CDCl₃ at 77.0 ppm.Typically, the approximate number of scans collected for adequatesignal-to-noise ranged from 300 to 1200 scans depending on theconcentration and purity of the sample. The total acquisition time forthe experiments ranged between 2-8 h e.g 1272 scans; data points 65,536.Concentrated solutions up to 20% w/v were employed when possible toreduce the acquisition time The chemical shifts quoted vary with theconcentration of the solution.

Biological Studies Chronic Relapsing Experimental AutoimmuneEncephalomyelitis (CREAE) Studies. Induction and Clinical Assessment ofEAE

CREAE was induced in C57B1/6 and SJL mice. Animals were injectedsubcutaneously with 100 μg of the neuroantigen peptide MOG 35-55 (aminoacid sequence MEVGWYRSPFSRVVHLYRNGK Genemed Synthesis, Inc) or 1 mg ofmouse spinal cord homogenate (SCH), in phosphate buffered saline (PBS),emulsified by sonication for 10 min at room temperature, in incompleteFreund's adjuvant (DIFCO, Detroit, USA) supplemented with 480 μg ofmycobacteria tuberculosis and 60 μg of Mycobacteria butyricium (DIECO,Detroit, USA) on days 0 and 7 as described previously (Morris-Downes, MM., et al 2002). Tn addition to optimise the disease mice also received200 ng (intraperitoneally) of Bordetella pertussis toxin dissolved inPBS administered 1 hr and 24 hrs after immunization with the MOGneuroantigen and for SCH days 0, 1, 7 and 8.

Animals were weighed from day 5 onwards and examined daily for clinicalneurological signs by two experienced investigators and graded accordingto a previously validated grading scheme (Morris-Downes, M M. et al 2002and others): 0=normal; 1=limp tail and feet; 2=impaired righting reflex;3=partial hind limb paralysis; 4=complete hindlimb paralysis;5=moribund; 6=death. Animals exhibiting clinical signs of a lesserseverity grade than typically observed were scored as 0.5 less than theindicated grade.

Reference

Morris-Downes, M M., et al (2002). Pathological and regulatory effectsof anti-myelin antibodies in experimental allergic encephalomyelitis inmice. J. Neuroimmunol. 125. 114-124.

The mean group EAE score was compared for each test group compared to arespective control group by non-parametric statistical analysis (MannWhitney U Test).

All MOG-CREAE studies comprised a treatment control group (C-C-C orsaline as selected from the above study). Each structured lipid wastested at 3 dose levels, all treaments being orally administered for 2weeks from day 7 after inoculation. All treatment groups will contained10 animals. On completion of studies (day 21), brain and spinal cordwere be removed and half of the samples were processed for signs of CNSperivascular mononuclear leucocyte-infiltrated sites and demyelination.

Studies were as Follows:Study 2: Spinal cord homogenate (SCH) EAE in SJL mice. EAE Induction: 1mg SCH day 0+day 7 sc. 200 ng Pertussis toxin day 0, 1, 7 & 8 ip.10mice/group. Mice were treated from day 7 to 21 with CCC or CGC.Study 3: SCH EAE in SJL mice: Treatment was from PSD 7 to 21, both daysinclusive.Study 4: MOG EAE in C57BL mice: Treatment was from PSD 7 to 21, bothdays inclusive.Study 5: SCH EAE in SJL mice: Treatment was from PSD 5 to 18, both daysinclusive.Study 6: MOG EAE in C57BL mice: Treatment was from Days 5 to 21inclusive except C-DHLA-C group where treatment was from days 5 to 15inclusive. Animals were culled on PSD 25. [Five animals from anuntreated group, 3 animals from control CCC treatment group, 5 animalsfrom GGG 150 ul treatment group and 2 animals from GGG 350 ul treatmentgroup were sampled for histological analysis on PSD 20].Study 7: SCH EAE in SJL miceTreatment was from Days 6 to 20 inclusive.Study 2—Spinal cord homogenate (SCH) in SJL mice :-tested

-   -   CGC (50/150/350 ul); CCC (350 ul).    -   GGG. (50/350 ul)    -   [Severe disease observed]        Study 3—SCH/SJL mice:-tested    -   CCC (50/150/350 ul)    -   CGC (25/50/150/350 ul)    -   GGG (50/150/350 ul)    -   OGO. (25/50/150/350 ul)    -   [Severe disease observed]        Study 4—MOG/C57BL mice:-tested    -   CCC (50/150/350 ul)    -   CGC (25/50/150/350 ul)    -   GGG (50/150/350 ul)    -   OGO (25/50/150/350 ul)        Study 6—MOG/C57BL mice:-tested    -   CCC (150 ul)    -   C-DHLA-C (50 ul)    -   CAC (50/350 ul)    -   AAA (50/150 ul)    -   GCG (50 ul)    -   CGC (50 ul)    -   GGG (150/350 ul)    -   [Pathology: CCC; GGG]

Histological examination of the submitted samples of brain and spinalcord showed lesions typical of experimental allergic encephalomyelitis.

Localised and diffuse lesions were characterised by gliosis, myelinvacuolation, axonal degeneration and perivascular cuffing withlymphocytes, macrophages and neutrophils.

Spinal cord lesions were mostly located in subpial white matter andbrain lesions mostly occurred in the cerebellar white matter. Lesionswere more severe in the spinal cords than in the brains and whereas allanimals with brain lesions had lesions in the spinal cord, not allanimals with cord lesions had lesions in the brain.

Variation in the severity of changes between individual mice issummarised using a semi-quantitative five point grading system.

Untreated mice had histological scores of 3-4 which correlated with EAEscores of 1.5-3. One mouse showed little pathological change with a zeroscore. In the GGG treated mice, the majority showed no abnormalities.Two mice from this group had histological scores of 2 and 3 respectivelywhich correlated with EAE severity. scores of 1 and 1.5

The results of the four studies are shown in FIGS. 11 to 20 below

These show that the compounds G-G-G, A-A-A, C-G-C, C-DHGLA-C, and C-A-Care all capable of reducing severity of CREAE whereas compounds G-C-Gand C-C-C failed to treat the condition. Compound O-G-O is believed towork if the dose is adjusted.

As cautioned in the description, the arachidnoic acid compounds areeffective, but lead to death of some animals. Surviving animals had muchreduced disease. It is believed that the dose of these compounds may bereduced still further to provide survival with satisfactory treatment.

Some of the studies show a bell shaped response curve for compoundsC-G-C and G-G-G, suggesting that very high doses are not optimal, as setout above. Such dosing can be conveniently determined by those skilledart, eg. By dose escalatio and monitoring TGF-β1/TNF-α spontaneouslyrelease ratio changes from PBMCs.

Given the PCT/GB04/002089 high sn-2 γ-linolenic acid results, the lackof efficacy of low sn-2 black-current oil and G-C-G in CREAE and the lowdose efficacy of C-G-C and C-DHGLA-C in FIG. 20, it can be seen thatsn-2-γ-linolenic acid, dihomo-γ-linolenic acid and arachidonic acidlipids provide a novel treatment for MS that far exceeds any currenttherapy outcome in that lesions are repaired and difficult symptoms areresolved: decreasing EDSS over a period of years being so far unachievedin other treatments.

References

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TABLE 1 Compositional (% Total FAs) Characteristics of Various Oils andtheir Protective Effects in EAE INCIDENCE Treatment 18:2n-6 18:3n-618:2n-6/18:3n-6 18:1n-9 OF EAE FGO 17 20 0.6 35 0/10 BOO 37 24 1.5 153/10 EPO 71 9.4 7.5 9 7/10 SAF 66 — — 17 9/10 Controls — — — — 9/10 FGO,Fungal Oil; BOO, Borage Oil; EPO, Evening Primrose Oil, SAF, SafflowerOil.

TABLE 2 Treatment Groups- PCT/GB04/002089 Borage oil-MS trial MeanRelapse Rate Mean (in past Base Female Male two years) EDSS Number GroupPlacebo 7 4 2.6 3.9 11 Low Dose 5 2 2.9 3.5 7 High Dose 8 2 3.4 2.8 10Total 20 8 2.9 3.4 28

TABLE 3 Molecular Species Comparison of Triacylglycerol-GLA (TG-GLA),Ethyl-Ester-GLA (EE-GLA) and PCT/GB04/002089 Borago Officinalis Oil-GLA(BOR-GLA) in MOG-induced CREAE in SJL Mice Treatment No. with EAE MeanClinical Score Control 10/11 3.3 ± 1.3  EE-GLA^(a) 5/6 3.0 ± 0.8 TG-GLA^(a) 3/6 1.0 ± 1.3^(c) BOR-GLA^(b) 3/6 1.0 ± 1.2^(c) ^(a)Animalsgiven 100 μl of test lipid; ^(b)250 μl BOR-GLA given. Significance ofdifference compared with controls, ^(c)p < 0.05

TABLE 4 Effect of enriched black-currant seed oil (73% GLA) on theincidence of EAE % Incidence of EAE (Days after immunisation) 13 17 21Controls (n = 10) 60 90 10 Blackcurrant (n = 10) 10 80 70 Note:Blackcurrant oil delays the incidence but does not provide fullprotection. Animals were fed 7 days after sensitization (immunisation).

1-38. (canceled)
 39. A method of treating a patient in need of therapyfor a demyelinating neurodegenerative disease comprising administeringto that patient a therapeutically effective dose of a therapeuticallyeffective dose of a monoglyceride of general formula I

wherein R¹ is the a fatty acyl group of an essential polyunsaturatedfatty acid selected from γ-linolenoyl, γ-dihomolinolenoyl andarachidonoyl.
 40. A method as claimed in claim 39 wherein the disease ismultiple sclerosis.
 41. A method as claimed in claim 39 wherein thedisease is relapsing remitting multiple sclerosis, primary progressivemultiple sclerosis or chronic progressive multiple sclerosis.
 42. Amethod as claimed in claim 39 wherein the treatment is of cerebralimpairment after stroke, head trauma and intracranial bleeding,Alzheimer's disease or Parkinson's disease where there is demyelinationor neuronal damage.